Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 189436 | NY |
NPI | 1215007653 |
---|---|
Provider Name | Dipak Kholwadwala |
First Address | Manhasset, NY 11030 |
Second Address | Manhasset, NY 11030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |